A doctor performs prostate surgery at the University of Chicago Medical Center in this Sept. 13, 2011 file photo. UNIVERSITY OF CHICAGO MEDICAL CENTER, VIA AP

A new article by Consumer Reports analyzing effectiveness of various types of cancer screenings will hardly be the last word on the subject. The ratings are based on recommendations from the U.S. Preventive Services Task Force, whose work already is contentious among doctors and patients.

In the analysis published Wednesday, Consumer Reports advised against eight of the 11 testing protocols it examined. The only three whose benefits vastly outweigh the harms, the report says, are for cervical, colon and breast cancer.

"The medical and public-health community has systematically exaggerated the benefits of screening for years and downplayed the harms," said Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, in the article.

A big reason for the no-confidence vote in those tests is that the procedures have widely varying degrees of success in finding cancer in otherwise healthy people. For instance, the report sanctions the use of mammography but cites a 2009 study indicating that screening 1,000 women every two years prevents five deaths from breast-cancer, while producing 780 false-positive tests. Those erroneous results could lead to unnecessary and invasive treatment.

Well-meaning people who promote widespread testing, often for free at large public events, might not realize the screenings themselves can pose a danger: A high level of prostate-specific antigen (PSA) from a blood test likely would prompt a needle biopsy, which could cause an infection; colonoscopy carries the risk of a perforated colon; and it's still not known what the cumulative effect of the radiation from multiple scans is.

Dr. Jack Jacoub, a medical oncologist at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, criticized the magazine's simplistic message, saying the efficacy of different cancer tests is always a work in progress. "Patients should not be reassured by simple data presented in a form like this and say, 'This sounds like a good-risk cancer and I shouldn't be worried about it, and I'm not going to get that rectal exam.' These are discussions that must be had with their physicians."

CR's criticism of the PSA test for prostate cancer echoes that of the Preventive Task Force, an independent panel of experts established by Congress to come up with recommendations for treatments. Last year, the panel said harms from the PSA screening outweigh the benefits, since men under 50 rarely get prostate cancer, and it's such a slow-growing cancer that older men who develop it aren't likely to die from it.

The task force drew criticism in 2009 when it recommended that women, as long as they're healthy and not in a high-risk group, should wait until age 50 to begin regular mammograms. The American Cancer Society says women should get annual exams beginning at 40. The CR analysis said women age 50-75 should get a mammogram every two years, and that women younger or older than that should consult their doctors.

Dr. Dean Foster, medical director of the Prostate Cancer Research Institute in Los Angeles, said any test producing a worrisome result should be followed up with careful research and consultation with a physician to determine the next step. "The harm that concerns the task force comes from jumping the gun, and rushing into biopsy and treatment before finding the best care," he said.

But he knows first-hand how valuable testing can be. At age 57, his PSA level showed an alarming leap and he was subsequently diagnosed with prostate cancer. But he pondered his options for two years before deciding to have his prostate surgically removed. Since his operation, he hasn't had any recurrence or complications.

"In the PSA-testing era, we've seen an almost 25 percent reduction in mortality from prostate cancer, and we don't want to go back," said Foster, 62. "To blindly say, 'Don't get a PSA test because it leads to harm' is revisiting a time when three times as many men had found their cancer after it metastasized."

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